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Superior orbital fissure narrowing and tumor-associated pain in spheno-orbital meningiomas

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Acta Neurochirurgica Aims and scope

Abstract

Introduction

Spheno-orbital meningiomas (SOMs) represent a distinct subtype of meningioma characterized by their unique multi-compartmental invasion pattern. Previous studies have investigated correlations between SOMs and visual manifestations. However, our comprehension of pain associated with SOMs remains limited. This study aims to provide insight into the pathophysiology underlying SOM-related pain through measurements of tumor volume and superior orbital fissure (SOF) narrowing.

Methods

This retrospective study included patients who underwent surgical resection of a SOM between 2000 and 2022. Preoperative CT and/or MRI scans were analyzed, and the tumor volume of each segment was measured. Bony 3D reconstructions were used to measure the area of the SOF, and SOF narrowing was calculated.

Results

The study cohort included 66 patients diagnosed with SOMs, among which 25.8% (n = 17) presented with pain. Postoperatively, 14/17 (82.4%) of patients reported pain improvement. There was no significant correlation between the total volume or the volume of tumor within each compartment and the presence of pain on presentation (p > 0.05). The median SOF narrowing was significantly different between patients presenting with and without tumor-associated pain with median of 11 mm2 (IQR 2.8–22.3) and 2 mm2 (IQR 0–6), respectively (p = 0.005). Using logistic regression, a significant correlation between the degree of SOF narrowing and the presence of SOM-associated pain on presentation was identified, with an aOR of 1.2 (95% CI 1.12–1.3, p = 0.02).

Conclusion

While the exact cause of tumor-associated pain remains unclear, SOF narrowing seems to play a role in pain among SOM patients. Based on the radiological characteristics, SOF neurovascular decompression is recommended in SOM patients.

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Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine, Emory University, Atlanta, GA, USA

    Youssef M. Zohdy, Arman Jahangiri, Ali Alawieh, Matthew Agam, Megan Cosgrove, Fadi Jacob, Edoardo Porto, Justin Maldonado, Katherine E. Chandler, J. Manuel Revuelta Barbero, Erion De Andrade, Biren Patel, Leonardo Tariciotti, Silivia Vergara, Gustavo Pradilla & Tomas Garzon-Muvdi

  2. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Edoardo Porto

  3. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Samson A. Argaw

  4. Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Emory University, Atlanta, GA, USA

    Alejandra Rodas

Authors
  1. Youssef M. Zohdy
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  2. Arman Jahangiri
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  3. Ali Alawieh
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  4. Matthew Agam
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  6. Fadi Jacob
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  7. Edoardo Porto
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  9. Alejandra Rodas
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  10. Justin Maldonado
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  13. Erion De Andrade
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  16. Silivia Vergara
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  18. Tomas Garzon-Muvdi
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Contributions

All authors contributed to the study conception, and design was done by YMZ, GP, and TGM. Material preparation and data collection were done by SAA, AR, JM, and KEC. Analysis was done by YMZ, ARM, AA, and FJ. First draft of the manuscript was written by YMZ, AJ, MA, MC, EP, and JMRB. Manuscript was revised by EDA, BP, LT SV, GP, and TGM. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tomas Garzon-Muvdi.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Emory University IRB and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived given the retrospective nature of the study.

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Informed consent for publication was waived as all patients’ information was de-identified.

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The authors declare no competing interests.

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Zohdy, Y.M., Jahangiri, A., Alawieh, A. et al. Superior orbital fissure narrowing and tumor-associated pain in spheno-orbital meningiomas. Acta Neurochir 166, 113 (2024). https://doi.org/10.1007/s00701-024-05979-2

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